Question: I understand that pain-related issues, chronic pain syndrome, or adjustment disorders secondary to the rated entity would be included/covered by the impairment rating already made. In a case where someone reports depression or anxiety that is attributed to the initial injury/impairment, would that also be included in the initial impairment rating? Or would you try to rate the depression using Chapter 14, Mental and Behavioral Disorders, and combine the impairments?
Answer: If someone has a physical injury and subsequently has problems with anxiety and depression, it would be unusual to rate for impairment beyond that occurring from the chapters used to rate the physical injury. The AMA Guides, Sixth Edition explain in Chapter 17, The Spine and Pelvis, Section 17.3e, Mental and Behavioral Problems and Chronic Pain, that, “In unusual cases, a musculoskeletal injury or incident...
